人工关节无菌性松动的早期诊断

背景：人工关节无菌性松动是影响关节假体寿命最主要的因素。 目的：旨在探讨人工关节无菌性松动的早期诊断方法，以利于开展积极的早期治疗。 方法：由第一作者应用计算机检索PubMed、中国期刊全文数据库(CNKI)、维普数据库和万方数据库 1997-05/2010-10相关文献。在标题、摘要、关键词中以“aseptic loosening，artificial joint，prosthesis，osteolysis，early diagnosis”或“无菌性松动，人工关节，假体，骨溶解，早期诊断”为检索词进行检索。选择文章内容与假体无菌性松动有关者，同一领域文献则选择近期发表在权威杂志文章。初检得到182篇文献，根据纳入标准选择关于假体无菌性松动分析及处理的39篇文献进行综述。 结果与结论：假体无菌性松动和骨溶解与骨代谢异常和炎症反应之间的关系密切，所以骨代谢相关指标和磨损颗粒诱导炎症反应的相关细胞因子都可用于早期诊断；核素示踪剂不仅能显示组织器官形态，而且通过显示器官或组织的生理与生化过程来反映组织器官的功能，可早于影像学数周甚至数月发现病变。

Early diagnosis of artificial joint aseptic loosening

BACKGROUND:The most significant factor that affects the life span of joint prosthesis is the artificial joint aseptic loosening. OBJECTIVE:To explore the early diagnosis of artificial joint aseptic loosening methods in order to facilitate active early treatment. METHODS:A computer-based online search of PubMed database, CNKI database, VIP database and Wanfang database between May 1997 and October 2010 was performed to search related articles with the key words of “aseptic loosening, artificial joint, prosthesis, osteolysis, early diagnosis” in English or Chinese. Literatures related to aseptic loosening of prosthesis were selected; in the same field, the articles published lately in authoritative journals were preferred. A total of 182 literatures were primarily selected, and 39 documents of which addressing the analysis and treatment of aseptic loosening of prosthesis were involved for summary according to inclusion criteria. RESULTS AND CONCLUSION:Aseptic loosening of prosthesis and osteolysis has a close relationship with abnormality of bone metabolism and inflammatory reaction. Therefore, related cytokines of inflammatory reaction induced by bone metabolic markers and wear particles can be used for early diagnosis. Isotopic tracer can not only displays the morphology of tissue and organ, but also reflects the function of tissues and organs by showing physiological and biochemical processes of organs or tissues. Pathological changes can be found earlier than imaging for a few weeks or even months.